What is the Difference Between Apexification and Apexogenesis?

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Apexification and apexogenesis are two different dental procedures used to treat teeth with incompletely formed roots or open apices (root tips). They serve different purposes and are applied in different scenarios.

Apexification:

  • Apexification is a procedure used to induce a calcified barrier at the apex of a nonvital tooth with incomplete root formation.
  • It involves removing unhealthy pulp and placing medication into the root, which encourages hard tissue to form near the root tip and act as a barrier for the root canal filling.
  • Once the barrier is fully formed, a traditional root canal and restoration can be completed.

Apexogenesis:

  • Apexogenesis refers to a vital pulp therapy procedure performed to encourage the physiological development and formation of the root end.
  • It is used to treat pulp exposure on a tooth with an open apex, allowing for continued root formation and apical (root tip) closure.
  • The procedure involves covering the exposed pulpal tissue with a calcium hydroxide compound, which allows the pulp to heal, preserving its vitality and encouraging the tooth to mature and strengthen naturally.
  • If the pulp heals, the tooth can be treated with a traditional root canal procedure if needed.

In summary, apexification is used for nonvital teeth with open apices, creating a calcified barrier at the root tip, while apexogenesis encourages the physiological development and formation of the root end in vital teeth with open apices.

Comparative Table: Apexification vs Apexogenesis

Here is a table comparing the differences between apexification and apexogenesis:

Feature Apexification Apexogenesis
Objective Creates a barrier in teeth with dead pulp Maintains pulp vitality for natural root development
Procedure Forms a calcified barrier over the open apex of the tooth Encourages continued root formation and apical closure
Pulp Involvement Pulp inside the tooth is dead or non-vital Involves a vital pulp
Tooth Type Immature permanent teeth with open apex Injured, immature permanent teeth with open apex
Treatment Focus Induces closure of non-vital permanent teeth Preserves pulp vitality and encourages natural tooth development
Materials Calcium hydroxide, MTA, tricalcium phosphate, dentin chips, calcium phosphate ceramics, hydroxyapatite, and bone morphogenetic proteins Calcium hydroxide USP (CaOH)
Outcome Hard tissue forms near the root tip, acting as a barrier for the root canal filling Allows the pulp to heal, preserving its vitality and encouraging the tooth to mature and strengthen naturally

Both apexification and apexogenesis are dental procedures used to treat teeth with open apexes, but they have different objectives and outcomes. Apexification focuses on creating a barrier in teeth with dead pulp, while apexogenesis aims to maintain pulp vitality for natural root development.